October is Breast Cancer Awareness Month, and New York-based Trinidadian doctor Dr Marshalee George, has contributed several short articles about breast cancer awareness. In this article, the Johns Hopkins University surgeon explains the factors affecting a woman’s risk for breast cancer.
Breast cancer consists of cells that grow in an uncontrolled way and can be primarily in the breast or spread to the lungs, liver, brain and bones. One in eight women are at risk of getting breast cancer.
Only 15 per cent of women that get breast cancer have a family history of breast cancer, while the other 85 per cent of breast cancers are diagnosed in individuals without family history. Five per cent to ten per cent of breast cancers are linked to inherited gene mutations (BRCA1/BRCA2). Both men and women can be carriers of these gene mutations and are at risk for breast and other types of cancer.
T&T has the highest rate of cancer mortality in the Americas, followed by Cuba and Argentina. Breast cancer has the highest mortality rate among women in T&T. During January 1998 to December 2007, the National Cancer Registry reported that 5942 women died from breast cancer in T&T. This number could be higher today because of population growth and the inability to capture mortality rates of women who died from breast cancer without seeking treatment.
Generally, Caucasians are diagnosed the most with breast cancer worldwide (40 and older); while African women and women of mixed race die from breast cancer the most. African women and women of mixed race tend to have a more aggressive type of breast cancer that can also be estrogen or progesterone hormone resistant. Note that when a woman has a breast cancer that is sensitive to estrogen and progesterone hormones, treatment is more effective and their cancer is more likely to be cured.
Most common signs and symptoms of breast cancer is a lump or mass in the breast. Other possible signs of breast cancer are nipple discharge or redness, breast or nipple pain, swelling or dimpling of the breast, rash or sore on the breast, painless lump or mass under the armpit, unusual thickening of the breast, and one breast lower than the other.
Women can reduce the risk factors for breast cancer by exercising, breast feeding, avoiding use of hormonal therapy (post menopause), refraining from or minimising alcohol intake, getting tested for the breast cancer gene mutation.
Breast Cancer Screening and self-breast exam can save your life.
Every woman should have a screening mammogram annually starting at age 40. If a woman has a close relative (such as a mother or sister) diagnosed with breast cancer at the age of 45 or older, she should start screening mammograms at age 35. If your relative had breast cancer younger than age 45, then screening mammograms should start 10 years earlier than your relative’s age at diagnosis. If your lifetime risk for breast cancer is more than 20 per cent based on family history then a Breast MRI may be recommended as an adjunct to mammography. Women between 25 and 39 should start having a clinical breast exam by their doctor or gynecologist every one to three years.
Men do get breast cancer. Male breast cancer is 100 times less common than women (one in 1000). However, when men get breast cancer it tends to be aggressive and is often associated with the breast cancer gene mutation (BRCA1/BRCA2). Therefore, men should also do self-breast or chest exams and contact their doctor if they have some of the common signs and symptoms described above.
SOME risk factors for breast CANCER
High intake of alcohol, being overweight, strong family history, early menstruation, dense breasts on mammogram, older age, use of estrogen or progesterone hormonal therapy, oral contraceptives, having first child over 30 and older age at menopause.
Benefits of mammography
1. Finds about 80-90 per cent of breast cancer in women with no symptoms.
2. Reduce mortality by 20 per cent-35 per cent in women 50-69 years; and
3. Reduce mortality by 20 per cent in women 40-49.
Complete a self-breast exam monthly starting at age 20, to know what your breast feels like, then you will be able to identify a change that was not there before.